ABSTRACT
Introduction: Respiratory viruses are among the leading causes
of disease and death among children. Co-circulation of influenza and
SARS-CoV2 can lead to diagnostic and management difficulties given the
similarities the clinical picture.
Methods: This is a cohort of all children hospitalized with
SARS-CoV2 infection from March to September 3rd 2020, and all children
admitted with influenza throughout five flu-seasons (2013-2018) at a
pediatric referral hospital. Patients with influenza were identified
from the clinical laboratory database. All hospitalized patients with
confirmed SARS-CoV2 infection were followed-up prospectively.
Results: A total of 295 patients with influenza and 133 with
SARS-CoV2 infection were included. The median age was 3.7 years for
influenza and 5.3 years for SARS-CoV2. Comorbidities were frequent in
both groups, but they were more common in patients with influenza
(96.6% vs 82.7%, p <0.001). Fever and cough were the most
common clinical manifestations in both groups. Rhinorrhea was present in
more than half of children with influenza but was infrequent in those
with COVID-19 (53.6 vs 5.8%, p<0.001). Overall, 6.4% percent
of patients with influenza and 7.5% percent of patients with SARS-CoV2
infection died. In-hospital
mortality and the need for mechanical ventilation among symptomatic
patients were similar between groups in the multivariate analysis.
Conclusions: Influenza and COVID-19 have a similar picture in
pediatric patients, which makes diagnostic testing necessary for
adequate diagnosis and management. Even though most cases of COVID-19 in
children are asymptomatic or mild, the risk of death among hospitalized
patients with comorbidities may be substantial, especially among
infants.
Keyword: Influenza, SARS-CoV2, COVID-19, children, clinical
characteristics, outcome.